<?php
echo '<table>';
echo '<form action="index.php" method=POST>';
echo '<tr class="linia"><td class="linia">Nazwisko</td><td class="linia"><input type=text size=25 name="pac_naz" value="'.$_SESSION['nazw'].'"></td></tr>';
echo '<tr class="linia"><td class="linia">Imię</td><td class="linia"><input type=text size=25 name="pac_imie" value="'.$_SESSION['imie'].'"></td></tr>';
echo '<tr class="linia"><td class="linia">Pesel</td><td class="linia"><input type=text size=11 name="pac_pesel" value="'.$_SESSION['pesel'].'"></td></tr>';
echo '<tr class="linia"><td class="linia">Data ur.</td><td class="linia"><input type=text size=11 name="pac_dataur"></td></tr>';
echo '<tr class="linia"><td class="linia">Miasto</td><td class="linia"><input type=text size=25 name="pac_miasto"></td></tr>';
echo '<tr class="linia"><td class="linia">Kod pocztowy</td><td class="linia"><input type=text size=6 name="pac_kod"></td></tr>';
echo '<tr class="linia"><td class="linia">Ulica</td><td class="linia"><input type=text size=6 name="pac_ulica"></td></tr>';
echo '<tr class="linia"><td class="linia">Nr domu</td><td class="linia"><input type=text size=6 name="pac_nrdom"></td></tr>';
echo '<tr class="linia"><td class="linia">Nr lokalu</td><td class="linia"><input type=text size=6 name="pac_nrlok"></td></tr>';
echo '<tr class="linia"><td class="linia">Telefon</td><td class="linia"><input type=text size=6 name="pac_tel"></td></tr>';
echo '<tr class="linia"><td class="linia" colspan=2 align="center"><input type="submit" class="butt" name="form_dod_pac" value="Zapisz"></td></tr>';
echo '</form>';
echo '</table>';
?>